多西紫杉醇联合卡培他滨治疗蒽环类耐药的晚期乳腺癌

目的：观察多西紫杉醇联合卡培他滨方案治疗对蒽环类耐药的晚期乳腺癌的疗效及毒副反应。方法：24例患者给予多西紫杉醇75mg/m^2静滴d1,卡培他滨1650mg/m^2.d,口服,d1-d14。21天为1周期,至少用2个周期,中位化疗周期数3个（2-4周期）。结果：总有效率41.7%,疾病控制率为83.3%,中位生存期16.5个月,主要毒副作用为骨髓抑制和脱发。结论：多西紫杉醇联合卡培他滨治疗对蒽环类耐药的晚期乳腺癌疗效好,毒副作用轻,是治疗对蒽环类耐药晚期乳腺癌较好的方案。     

卡培他滨联合多西紫杉醇治疗蒽环类耐药的晚期乳腺癌

目的观察卡培他滨联合多西紫杉醇治疗葸环类耐药的晚期乳腺癌的疗效与安全性。方法于2001年9月至2005年5月，41例蒽环类耐药的晚期乳腺癌患者实施了卡培他滨联合多西紫杉醇方案化疗，卡培他滨1000～1250m/m^2口服，每日2次，第1～14天；多西紫杉醇60～75mg／m^2，静滴，第1天或30～37．5m/m^2，静滴，第1、8天；21d为1周期。每例至少治疗2周期后评价疗效，中位化疗周期数为4（2～8）周期。结果在38例可评价疗效的患者中，完全缓解（CR）4例（10．5％），部分缓解（PR）18例（47．4％），稳定（SD）11例（28．9％），进展（PD）5例（13．2％），总有效率（CR＋PR）为57．9％，疾病控制率（cR＋PR＋SD）为86．8％，中位肿瘤进展时间（TTP）9．1个月，中位生存期18．4个月。主要毒性反应为骨髓抑制和胃肠道反应。结论卡培他滨和多西紫杉醇联合方案治疗蒽环类耐药的转移性乳腺癌疗效好，使用方便，耐受性良好，适合于体质状态稍差的老年患者，可作为蒽环类耐药的晚期乳腺癌的有效解救治疗方案。     

多西紫杉醇联合卡培他滨治疗蒽环类耐药的转移性乳腺癌

目的 观察多西紫杉醇联合卡培他滨(DC方案)治疗蒽环类耐药的晚期乳腺癌的疗效和安全性.方法 选择32例葸环类耐药的转移性乳腺癌患者,给予DC方案化疗.根据WHO制定的实体瘤客观疗效评价标准和抗癌药物毒性分级(0～Ⅳ)标准评价疗效和不良反应.结果 32例患者共完成126个周期化疗,每例患者的化疗周期数为2～12个,中位化疗周期数4个.完全缓解(CR)1例,部分缓解(PR)14例,稳定(SD)11例,进展(PD)6例,总有效率为46.9%.14例肺转移患者中8例有效,13例肝转移患者中6例有效,7例皮肤软组织转移患者中3例有效,5例淋巴结转移患者中3例有效.32例患者的中位肿瘤进展时间(TTP)为5.6个月.1年生存率为56.3%.主要不良反应为骨髓抑制、手足综合征、恶心、呕吐、腹泻、口腔黏膜炎等,84.4%的患者出现中性粒细胞下降,2例达Ⅳ度骨髓抑制.结论 DC方案治疗转移性乳腺癌的有效率高,不良反应可以耐受,是治疗对蒽环类耐药转移性乳腺癌的有效方案.     

多西紫杉醇联合卡培他滨治疗晚期乳腺癌的临床观察

目的:观察多西紫杉醇联合卡培他滨治疗晚期乳腺癌的临床疗效及不良反应.方法:38例晚期乳腺癌患者,采用多西紫杉醇75mg/m2,d1;卡培他滨1000mg/m2,bid,d1-14,21天为1个周期.结果:38例乳腺癌患者中,CR 4例,PR 18例,SD 11例,PD 5例,有效率(CR+PR)57.89%.不良反应主要为胃肠道反应、骨髓抑制、脱发、手足综合症.结论:多西紫杉醇联合卡培他滨治疗晚期乳腺癌疗效确切,不良反应可以耐受,可作为晚期乳腺癌的一个较理想方案.     

多西紫杉醇联合卡培他滨治疗晚期乳腺癌的临床观察

目的：观察多西紫杉醇联合卡培他滨治疗晚期乳腺癌的临床疗效及不良反应。方法：38例晚期乳腺癌患者,采用多西紫杉醇75mg／m^2,d1;卡培他滨1000mg／m^2,bid,d1-14,21天为1个周期。结果：38例乳腺癌患者中,CR4例,PR18例,SD11例,PD5例,有效率（CR＋PR）57．89％。不良反应主要为胃肠道反应、骨髓抑制、脱发、手足综合症。结论：多西紫杉醇联合卡培他滨治疗晚期乳腺癌疗效确切,不良反应可以耐受,可作为晚期乳腺癌的一个较理想方案。     

多西紫杉醇联合卡培他滨治疗乳腺癌肝转移的临床观察

目的：观察多西紫杉醇联合卡培他滨（TX）序贯卡培他滨单药维持治疗乳腺癌肝转移（breast cancerliver metastases,BCLM）的疗效和安全性。方法：回顾性分析TX方案治疗蒽环/和紫杉类药治疗的乳腺癌肝转移患者39例。全组共化疗230周期,中位周期数6周期（4-8周期）。有效者TX方案化疗6-8周期后序贯卡培他滨单药维持直至不能耐受或病情进展。结果：全组39例患者,4周期化疗后CR0例,PR20例（51.3%）,SD14例（35.9%）,PD 5例（12.8%）,有效率51.3%,临床获益率87.2%。TTP 2.8-36.5月,中位TTP5月。结论：应用TX方案序贯卡培他滨维持治疗蒽环/和紫杉类治疗后乳腺癌肝转移疗效确切,毒副反应能耐受,值得临床推广。     

多西紫杉醇联合卡培他滨治疗蒽环类药物耐药性晚期乳腺癌的初步临床结果

目的观察多西紫杉醇(docetaxel)联合卡培他滨(capecitabine)治疗蒽环类耐药性晚期乳腺癌的疗效.方法2002年6月～2003年10月,以此方案治疗蒽环类药物耐药的晚期乳腺癌16例.全组化疗共52周期,中位周期数3周期(2～6周期).结果CR 2例,PR 7例,SD 4例,PD 3例,总有效率(CR PR)56.2%.全组中位缓解期5个月(2～14个月).主要剂量毒性为骨髓抑制、胃肠道反应和手足综合征,骨髓抑制以白细胞减少为主,Ⅲ～Ⅳ度白细胞减少发生率为18.7%.结论多西紫杉醇联合卡培他滨对蒽环类药物耐药的转移性乳腺癌有较好的疗效,且毒性可以耐受,可以考虑作为解救化疗方案.     

多西紫杉醇联合卡培他滨治疗转移性乳腺癌的疗效分析

目的探讨多西紫杉醇联合卡培他滨（DC方案）治疗转移性乳腺癌的临床疗效。方法选择79例转移性乳腺癌患者,均采用DC方案化疗,然后评价患者的临床疗效及不良反应。结果79例患者在本研究中共完成300个化疗周期,中位化疗周期数3．8个。总有效率为50．6％,其中CR3例（3．8％）。化疗主要不良反应有乏力、骨髓抑制、手足综合征、胃肠道反应、口腔黏膜炎等。65例患者出现中性粒细胞下降,其中5例达Ⅳ度骨髓抑制。中位随访时间为10．5个月,中位无进展生存期（progression—free survival,PFS）为5．8个月。结论多西紫杉醇联合卡培他滨方案治疗转移性乳腺癌的有效率高,疗效肯定,不良反应可以耐受,是治疗转移性乳腺癌的有效方案。     

多西紫杉醇联合卡培他滨治疗蒽环类耐药的晚期乳腺癌

目的:观察多西紫杉醇联合卡培他滨方案治疗对蒽环类耐药的晚期乳腺癌的疗效及毒副反应.方法:24例患者给予多西紫杉醇75mg/m2静滴d1,卡培他滨1650 mg/m2*d,口服,d1-d14.21天为1周期,至少用2个周期,中位化疗周期数3个(2-4周期).结果:总有效率41.7%,疾病控制率为83.3%,中位生存期16.5个月,主要毒副作用为骨髓抑制和脱发.结论:多西紫杉醇联合卡培他滨治疗对蒽环类耐药的晚期乳腺癌疗效好,毒副作用轻,是治疗对蒽环类耐药晚期乳腺癌较好的方案.     

多西紫杉醇联合卡培他滨治疗晚期乳腺癌22例的临床观察

背景与目的：对于复发转移性乳腺癌，卡培他滨和紫杉醇类药物均有确切肯定的疗效，由于紫杉醇类药物能增强肿瘤组织的TP活性，因而与卡培他滨有协同作用。本研究观察及评价多西紫杉醇联合卡培他滨治疗复发转移性乳腺痈的疗效和不良反应。方法：22例晚期乳腺癌患者均给予多西紫杉醇75mg／m^2，第1天；卡培他滨口服每日2次，餐后服用，1000mg／m^2／次，连续服用14天，治疗周期为21天，至少治疗2个周期。结果：本组完全缓解（CR）3例，部分缓解（PR）12例，稳定（SD）6例，疾病进展（PD）1例，总有效率68．2％，中位TTP6．5个月。不同转移部位或器官的有效率分别为：胸壁85．7％（6／7）；淋巴结80．0％（8／10）；肺脏75．0％（6／8）；骨骼40．0％（2／5）；肝脏30．0％（3／10）。Ⅰ／Ⅱ级不良反应为皮肤色素沉着16例，手足综合征14例，恶心呕吐12例，腹泻10例，白细胞下降16例。Ⅲ／Ⅳ级不良反应白细胞下降3例，恶心呕吐1例，贫血1例。结论：多西紫杉醇联合卡培他滨治疗晚期乳腺癌疗效肯定，患者耐受性良好。     

Haematologic Parameters in Metastatic Colorectal Cancer Patients Treated with Capecitabine Combination Therapy

Background: The standard treatment in the metastatic colorectal cancer consists of 5-FU based infusionalregimens. However, with oral fluoropyrimidines, equal tumor responses may be obtained. Capecitabine causesmacrocytosis of the cells by inhibition of DNA synthesis. In this context, a relationship was found between meancorpuscular volume (MCV) and response to therapy in breast cancer patients treated with Capecitabine, butwhether this relationship also pertains in colorectal cancer has not been established. Materials and Methods: Atotal of 102 metastatic colorectal cancer patients treated with a oxaliplatin (XELOX)±Bevacizumab combinationwere retrospectively evaluated. Patients were randomized into three groups. Hematological parameters (MCV,MPV, PCT, PLT, NLR) were recorded retrospectively, before treatment and after 3 cycles of chemotherapy.Results: After three cycles of therapy, 20 (19.6%) patients had progressive disease (PD), 41 (40.1%) hadstable disease (SD), and 41 (40.1%) demonstrated a partial response (PR). In 62 (60.7%) treatment was withcapesitabin plus XELOX therapy, and in 40 (39.2%) it was XELOX-Bevacizumab combination therapy. Therewas no difference among three groups before the treatment in terms of MCV, MPV, PCT, PLT, and NLR.MCV showed significant increase in chemotherapy response groups (PR and SD). In addition, a significantdecrease was observed for platelet count in chemotherapy response groups. While NLR decrease was seen inonly a PR group, PCT decrease was observed in all three groups. PCT and PLT values were higher in patientsreceiving Bevacizumab. Conclusions: PLT, PCT, MPV, and NLR values were decreased due to Capecitabinebasedchemotherapy, however MCV was increased. PCT and PLT values were higher in patients who receivedBevacizumab than those who did not. MCV, PLT, and NLR can be considered as important factors in predictingresponse to colorectal carcinoma treatment.     

泰索帝治疗转移性乳腺癌临床观察

对29例转移性乳腺癌泰索帝75mg/m^2，静脉滴注1小时，连续3天，21天为1周期，4个周期评价疗效。结果：CR4例，PR17例，NC6例，PD2例，有效率72．4％，不良反应主要为白细胞减少，脱发，腹泻等。     

多西他赛联合希罗达治疗蒽环类失败的转移性乳腺癌的临床研究

目的 研究多西他赛（docetaxel）联合希罗达（Xeloda）治疗蒽环类治疗失败的转移性乳腺癌的疗效及可行性.方法 对12例含蒽环类方案治疗失败的复发转移性乳腺癌患者,采用多西他赛联合希罗达方案治疗,多西他赛37.5 mg/m^2静脉滴注,第1、8天;希罗达900 mg/m^2 ,口服,每日2次,第1～14天,每3周为1个周期.每个周期评价疗效,记录不良反应.结果 12例患者均可评价疗效,2例（16.7%）完全缓解（CR）,5例（41.7%）部分缓解（PR）,4例（33.3%）疾病稳定（SD）,1例（8.3%）疾病进展 （PD）,总有效率（CR＋PR）为58.3%,肿瘤控制率（CR＋PR＋SD）为91.7%.不良反应主要为骨髓抑制、胃肠道反应和手足综合征,均可耐受,无治疗相关死亡患者.结论 多西他赛联合希罗达治疗蒽环类治疗失败的转移性乳腺癌有较好的疗效,不良反应可以耐受,可以作为转移性乳腺癌的解救化疗方案.     

吉西他滨联合紫杉醇方案与长春瑞滨单药方案治疗蒽环类耐药的转移性乳腺癌的临床观察

目的：：评价吉西他滨联合紫杉醇方案与单药长春瑞滨方案在治疗蒽环类耐药的转移性乳腺癌患者中的疗效及不良反应。方法：2009年10月至2012年12月,我科收治的符合治疗条件的晚期乳腺癌患者共126例,随机分为吉西他滨联合紫杉醇组（GT 组）及单药长春瑞滨组（NVB 组）,观察有效率（RR）、疾病控制率（DCR）、无进展生存期（PFS）、总生存期（OS）及不良反应。采用χ2检验比较各组治疗有效率、疾病控制率及不良反应,采用Kaplan -Meier 法计算生存率,采用 Log -rank 检验进行生存率的比较。结果：GT 组较 NVB 组在 RR 及 OS 方面有优势（P ＝0.033;P ＝0.013）,在 DCR、PFS 方面差异无统计学意义（P ＝0.440;P ＝0.159）,在不良反应方面有较多的中重度白细胞减少（P ＝0.025）、轻度恶心呕吐（P ＝0.035）、便秘（P ＝0.030）、肌肉关节疼痛（P ＝0.000）及疲乏无力（P ＝0.003）。结论：对于身体状况较好的患者,使用吉西他滨联合紫杉醇方案较单药长春瑞滨方案有助于提高患者的 RR 及 OS,但需注意不良反应的监测及相应的处理。     

A Pooled Analysis of Gemcitabine Plus Docetaxel Versus Capecitabine Plus Docetaxel in Metastatic Breast Cancer

Introduction.

In two randomized phase III trials of patients with metastatic breast cancer (MBC), gemcitabine-docetaxel (GD) and capecitabine-docetaxel (CD) had similar efficacy, but distinct safety profiles.

Methods.

Data from two GD versus CD studies were pooled; overall survival (OS), progression-free survival (PFS), and overall response rate (ORR) were determined. Cox proportional hazards models identified prognostic factors associated with improved OS and PFS. Using a multivariate prognostic model incorporating identified adverse prognostic factors, we grouped MBC patients into low-, intermediate-, and high-risk categories. Hazard ratios (HRs) of GD over CD for OS and PFS were determined for subsets of patients.

Results.

Baseline demographics of the pooled population were mostly well balanced. In the pooled population, there were no significant differences between GD versus CD for OS (HR = 1.02; p = .824), PFS (HR = 1.15; p = .079), and ORR (p = .526). In the pooled crossover population, there were trends toward improved OS (HR = 0.82; p = .171) and PFS (HR = 0.93; p = .557) with GD. Several prognostic factors (including prior adjuvant taxane) for improved OS or PFS were identified; however, there were no significant interactions between treatment arms and prognostic factors for PFS or OS, except number of metastatic sites. In the prognostic model, median OS and PFS were numerically lower in the high-risk group versus the intermediate- and low-risk groups.

Conclusion.

This analysis confirms the lack of efficacy difference between GD and CD in the pooled population, crossover population, and almost all subpopulations. Several prognostic factors were associated with improved outcomes in the pooled population.     

Capecitabine in Combination with Docetaxel in First Line in HER2-Negative Metastatic Breast Cancer: an Observational Study

Due to the limited experience with capecitabine plus docetaxel (XT) combination in the first-line treatment of metastatic breast cancer in Hungary, the main objective of the study was to analyze the effectiveness and tolerability of XT therapy. A prospective, open-label, non-randomized, single-arm, multicenter, observational study was designed. All female patients were eligible whose metastatic breast cancer could be treated with the XT protocol according to the summary of product characteristics of the drugs. The median progression free survival was 9.9 ± 3.0 months. Time to treatment failure was 4.6 ± 5.1 months on average. The overall response rate was 28.9 %, the clinical benefit rate was 73.3 %. The treatment was discontinued in 35.6 % of patients due to disease progression and in 20.0 % due to adverse events (AE). 33 patients with a total of 73 AEs have been reported, and 13 of them had serious adverse events (SAE). The efficacy and the safety profile of XT chemotherapy proven in the study are consistent with the results demonstrated in randomized trials. First-line XT chemotherapy effectively improves the PFS in metastatic breast cancer.     

奥沙利铂联合卡培他滨一线治疗晚期转移性胃癌的临床疗效观察

目的探讨奥沙利铂联合卡培他滨作为一线方案治疗晚期转移性胃癌的疗效和安全性。方法27例既往未接受过化疗的晚期转移性胃癌患者采用奥沙利铂联合卡培他滨（XELOX方案）化疗：奥沙利铂130 mg/m²,静脉滴注2小时,d1;卡培他滨2 000 mg/m²,分2次口服,d1～14,21天为一周期。患者最多接受8个周期化疗。结果27例患者共接受124个周期化疗,中位化疗周期数为5个。所有患者均可评价疗效,其中部分缓解12例(44.5%),稳定8例(29.6%), 进展7例(25.9%);客观有效率44.5%(95%可信区间:25.8%～63.2%)。平均随访9.2月,中位疾病进展时间5.0月（95%可信区间：2.6～7.4月）,中位生存时间9.7月（95%可信区间：6.5～12.9月）。常见不良反应有骨髓抑制、外周神经毒性、胃肠道反应、手足综合征等,无治疗相关性死亡。结论XELOX方案一线治疗晚期转移性胃癌疗效显著,耐受性良好。